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Fu-shen 16 is inspired by Bupleurum and Dragon Bone Combination (Chaihu Jia Longgu Muli Tang) and Achyranthes and Hematite Combination (Zhengan Xifeng Tang; see Ancient and Modern Formulas). These formulas are aimed at treating liver agitation causing both mental and physical distress. The common ingredients with these two base formulas are the heavy sedative agents dragon bone, oyster shell, and hematite (with haliotis added here). The formula was modified in light of another formula with similar application: Iron Filings Decoction (Sheng Tieluo Yin), which uses hematite (iron filings), polygala, fu-shen, and uncaria to help treat a depressive and/or manic-type disorder due to flaring of fire. Fu-shen 16 also includes the hot/cold pair of cinnamon bark and coptis; it is believed that these ingredients used together not only harmonize their own divergent natures and tastes, but also settle a conflict between the heart and kidney. The yang energy of the kidney can agitate the fire of the heart, but this is not always treated by cooling the kidney yang; in this case, the kidney is warmed slightly to aid rooting of the yang, thus protecting the heart, which is cooled by coptis. This formula is useful for persons who suffer from mental and physical agitation that results from excessive fire of the liver and heart and who might not tolerate stirring of the liver (as can occur when administering bupleurum-based formulas). If there is liver yin and blood deficiency, one should add a tonic formula (e.g., Tortoise Shell Tablets, Shou Wu Tablets, Tang-kuei 18) at the same time; for phlegm accumulation accompanying the fire syndrome, Bamboo 11 can be added.
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